Individual
LUKE LACZAK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PT, DPT
Contact information
Practice address
159 W 1ST ST, OSWEGO, NY 13126-2045
(607) 727-6739
Mailing address
212 SENECA AVE, 36 GRAMPIAN ROAD, BALDWINSVILLE, NY 13027-9132
(607) 727-6739
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
033292
NY
Other
Enumeration date
11/11/2011
Last updated
11/11/2011
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